Comparison of different pain scoring systems in critically ill patients in a general ICU

Ahlers, Sabine; Gulik, Laura van; Veen, Aletta M. van der; Dongen, H.P.A. van; Bruins, Peter; Belitser, Svetlana V.; Boer, Anthonius de; Tibboel, Dick; Knibbe, Catherijne A. J.

doi:10.1186/cc6789

Cited by 180 publications

(148 citation statements)

References 27 publications

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“…The VAS may be considered a continuous measurement scale (van Dijk et al 2012). Accurate administration requires: a clearly readable scale with descriptors, the participant's understanding and co-operation, and adequate response time (van Dijk et al 2012, Ahlers et al 2008). The VAS is suitable for obtaining self-reports on the status of pain from ventilator-dependent patients for both routine clinical and research purposes (Ahlers et al 2008, Aissaoui et al 2005, HamillRuth & Marohn 1999.…”

Section: Methodsmentioning

confidence: 99%

Effects of Natural Sounds on Pain: A Randomized Controlled Trial with Patients Receiving Mechanical Ventilation Support

Saadatmand

Rejeh

Heravi‐Karimooi

et al. 2015

Pain Management Nursing

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Background: Non-pharmacological pain management in patients receiving mechanical ventilation support in critical care units is under-investigated. Natural sounds may help reduce the potentially harmful effects of anxiety and pain in hospitalized patients.Aims: This article examines the effect of pleasant, natural sounds on self-reported pain in patients receiving mechanical ventilation support.Design: A pragmatic parallel arm randomised controlled trial. Settings:A general adult ICU of a high turnover teaching hospital, Tehran, Iran. Participants/Subjects: Sixty patients receiving mechanical ventilation supportMethods: Between Oct 2011 and June 2012, we recruited sixty patients receiving mechanical ventilation support to intervention (n=30), and control arms (n=30) of a pragmatic parallel group randomized controlled trial. Participants in both arms wore headphones for 90 minutes. Those in the intervention arm heard pleasant natural sounds, while those in the control arm heard nothing.Outcome measures included the self-reported Visual Analog Scale (VAS) for pain at baseline, and 30, 60, 90 minutes into the intervention and 30 minutes after the intervention.Results: All those approached agreed to participate. The trial arms were similar at baseline. In the intervention arm, pain scores fell and were significantly lower than in the control arm at each time point (p < 0. 05). Conclusions:Administration of pleasant natural sounds via headphones is a simple, safe, nonpharmacologic nursing intervention that may be used to allay pain for up to 120 minutes in patients receiving mechanical ventilation support.Key words: mechanical ventilation, nurse, nursing, pain, randomised controlled trial, sounds. 2 BackgroundPain is the fifth vital sign. Its management is central to the care of critically ill patients, but is sometimes misunderstood and poorly executed by nurses (Aslan et al. 2003, Summer & Puntillo et al. 2001, Shannon & Bucknall 2003, Higgins et al. 2004, Gélinas et al. 2004, Gélinas et al. 2006. Pain is frequently a barrier to caring, haemodynamic stability and healing (Cullen et al. 2001).The need for mechanical ventilation, to maintain adequate oxygenation and protect the airway, is one of the principal reasons for admission to Intensive Care Units (ICUs). Many medical conditions, critical illnesses and critical care procedures, such as intubation, suction, immobilization, repositioning, and invasive monitoring evoke pain (Stanik-Hutt 2003, Kwekkeboom & Herr 2001. Respiratory distress, hypoxemia, and mechanical ventilation, particularly the presence of endotracheal tubes and airway suctioning, may also induce anxiety, in addition to pain and discomfort (Tracy & Chlan 2011, Nelson et al. 2004, Costa et al. 2006, Pun & Dunn 2007. Therefore, provision of adequate care to mechanically ventilated patients usually entails administration of opioids not only to decrease pain and discomfort, but also tominimize the anxiety, tachypnoea and hypertension associated with the unpleasant experiences of endotracheal...

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Section: Methodsmentioning

confidence: 99%

Effects of Natural Sounds on Pain: A Randomized Controlled Trial with Patients Receiving Mechanical Ventilation Support

Saadatmand

Rejeh

Heravi‐Karimooi

et al. 2015

Pain Management Nursing

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“…The BPS was completed for all patients receiving mechanical ventilation; the NRS was either estimated by the bedside nurse or obtained from the patient if the patient was able to respond. Having a bedside nurse estimate the NRS score is a questionable practice, because this study 31 indicated that the NRS score as reported by the patient correlated with the score estimated by the Although designed for noncommunicative critically ill patients, the NPAT has not been validated in this population of patients.…”

Section: Behavioral Pain Scalementioning

confidence: 96%

“…Ahlers et al 31 obtained 371 independent determinations of the BPS and NRS (when possible) in 113 critically ill patients. The BPS was completed for all patients receiving mechanical ventilation; the NRS was either estimated by the bedside nurse or obtained from the patient if the patient was able to respond.…”

Section: Behavioral Pain Scalementioning

confidence: 99%

Observational Pain Scales in Critically Ill Adults

Stites

2013

Critical Care Nurse

100

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Pain is a common and distressing symptom in critically ill patients. Uncontrolled pain places patients at risk for numerous adverse psychological and physiological consequences, some of which may be life-threatening. A systematic assessment of pain is difficult in intensive care units because of the high percentage of patients who are noncommunicative and unable to self-report pain. Several tools have been developed to identify objective measures of pain, but the best tool has yet to be identified. A comprehensive search on the reliability and validity of observational pain scales indicated that although the Critical-Care Pain Observation Tool was superior to other tools in reliably detecting pain, pain assessment in individuals incapable of spontaneous neuromuscular movements or in patients with concurrent conditions, such as chronic pain or delirium, remains an enigma.

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“…(1)(2)(3)(4)(5) Moderate to severe pain is a common phenomenon experienced by patients in the Intensive Care Units (ICUs). (5) Multiple intrinsic and extrinsic sources contributing to this pain include underlying health conditions or disease, trauma, and routine care procedures.…”

Section: Introductionmentioning

confidence: 99%

Pain Assessment and Management in Critically Ill Intubated Patients in Jordan : A Prospective Study

Ayasrah¹,

O'Neill²,

Abdalrahim³

et al. 2014

IJHS

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Abstract:Objectives: The purpose of this study was to describe: (1) pain indicators used by nurses and physicians to assess pain, (2) pain management interventions (pharmacological and non-pharmacological) used by nurses, and (3) indicators used by nurses to verify pain intervention effectiveness. Methodology:A total of 301 medical records of currently admitted patients from six different ICUs in Jordan were reviewed using a data collection instrument developed by Gélinas et al. (2004) Pain-related indicators were classified into non-observable (patient's self-reports of pain) and observable (physiological and behavioral) categories. Results:Only 105 (35%) of a total 301 reviewed medical records contained pain assessment data. From these medical records, 15 pain episodes were collected altogether. Observable indicators documented 98% of the 115 pain episodes. Patients' selfreports of pain were documented only 1.7% of the time. In 78% and 46% of the 115 pain episodes, pharmacological and nonpharmacological interventions for pain management were documented, respectively. Only 37% of the pain episodes were reassessed with self-report (1%) and observable indicators (36%) to determine the effectiveness of the interventions. Conclusion:Pain documentation for assessment, management, and reassessment was lacking and needs improvement.

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Comparison of different pain scoring systems in critically ill patients in a general ICU

Cited by 180 publications

References 27 publications

Effects of Natural Sounds on Pain: A Randomized Controlled Trial with Patients Receiving Mechanical Ventilation Support

Effects of Natural Sounds on Pain: A Randomized Controlled Trial with Patients Receiving Mechanical Ventilation Support

Observational Pain Scales in Critically Ill Adults

Pain Assessment and Management in Critically Ill Intubated Patients in Jordan : A Prospective Study

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